P22 Does HCC surveillance improve survival rate? A retrospective comparative study between patients diagnosed within and outside surveillance over a 10 year period – A single centre study. (20th September 2022)

• Record Type: Journal Article
• Authors: Palanichamy, Swetha; Faulkes, Rosemary; Coldham, Chris; Humphries, Sian; Ma, Yuk Ting; Mehrzad, Homoyon; Dasari, Bobby; Perera, Thamara; Shetty, Shishir; Shah, Tahir
• Is Part Of: Gut. Volume 71(2022)Supplement 3
• Page Start: A47
• Page End: A47
• Publication Date: 2022-09-20
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2022-BASL.73
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: Surveillance for hepatocellular cancer [HCC] in patients with cirrhosis is accepted practice with some evidence of benefit1. We assessed for differences in patients diagnosed through surveillance versus diagnosed outside surveillance. Methodology: The hospital's HCC database was interrogated for patients diagnosed with HCC between 2012 and 2021. Only patients diagnosed within our institute were included. Electronic medical records were retrospectively studied. Data included age, gender, aetiology of cirrhosis, Childs Turcott Pugh (CTP), date of HCC diagnosis, tumour size, AFP level, treatments, date of death, and date of last follow-up. Treatment interventions were classified as curative or non-curative. Liver transplant, resection, Ablation, and stereotactic ablative body radiotherapy [SABR] for small sized tumour lesions were termed curative. Survival analysis was carried out using Kaplan Meier method. Results: 178 HCC patients were included. Mean age 65.3 years, 76% were male and 84% were Child Pugh A. 111 of 178 were diagnosed through surveillance (62.3%) while 67 patients (37.6%) were diagnosed through HCC related symptoms or incidentally. Mean age 64.4 (95% CI 62.1–66.7) and 66.9 (95%CI 63.6–70.2) years (P=0.045), 73% and 83.6% male, median AFP 6 (IQR 3–36) and 5 (IQR 3–37) IU/ML (P=0.805), mean size of the tumour 2.9 (95% CI 2.5–3.3) and 5.7 (95% CI 4.8–6.6) cm (P=0.000) between the two groups respectively. 33.3% vs 37.3% (P=1.000) received curative option, 66.7% vs 62.7% (P=1.000) received palliative treatment, 22% vs 18% lacked any form of treatment intervention. Survival at 1, 3 and 5 years was 87%, 54% and 43% in the surveillance group, and 75%, 50% and 34% in the non-surveillance group. 7.2% vs 58.2% (P=0.000) were non-cirrhotic in the surveillance and non-surveillance group. Conclusion: Real world data from a single centre over a ten year period demonstrates that HCC surveillance leads to diagnosis of tumours at an earlier stage, as shown by average tumour size in this cohort. Despite similar demographics and rates of treatment between the two groups HCC surveillance does not appear to translate to a significant difference in overall survival. The majority of non-surveillance group having non-cirrhotic livers likely explains the parity in survival between the 2 groups. However, we plan to explore this further, to understand how best to optimise surveillance in HCC. References: Harris PS, Hansen RM, Gray ME, Massoud OI, McGuire BM, Shoreibah MG. Hepatocellular carcinoma surveillance: An evidence-based approach. World J Gastroenterol . 2019;25 (13):1550–1559. doi:10.3748/wjg.v25.i13.1550